A national study measuring parental attitudes toward vaccinations found 6.1% were hesitant about routine childhood immunizations while nearly 26% were hesitant about the influenza vaccine.
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Rising coronavirus cases among Victorian health workers could threaten our pandemic response – The Conversation AU
Keeping health-care workers COVID-free is critical to delivering care to those who need it during a pandemic. What can we do to ensure they are better protected?
Over the past week, weve seen a spike in the number of COVID-19 infections among health-care workers in Victoria.
This includes a doctor at Melbournes St Vincents Hospital, one staff member at Brunswick Private Hospital, nine staff members from the emergency department at Melbournes Northern Hospital, and two nurses at the Royal Melbourne Hospital.
Staff at several aged care facilities have also tested positive.
These cases have meant sending many health-care workers regarded as close contacts into home quarantine.
The Northern Hospital emergency department has reportedly had to divert patients elsewhere, while Brunswick Private Hospital (where four patients tested positive too) is closed to new admissions.
Keeping health-care workers COVID-free is critical to delivering care to those who need it during a pandemic. So as Victorias second wave rolls on, we need to consider what more we can do to protect our health workers.
How we’ll avoid Australia’s hospitals being crippled by coronavirus
Why might this be happening?
In the absence of a vaccine, subsequent waves of COVID-19 have always been a possibility.
Health-care workers tend not to contract COVID-19 from patients, as appropriate personal protective equipment (PPE) is used in high risk encounters.
But health-care workers are normal people commuting to work and living and interacting in communities. So its more likely they contract it outside work.
Undetected, they can then bring it into the hospital or other health-care setting, putting fellow staff and vulnerable patients at risk.
Over the past week, weve seen a number of COVID-19 cases among hospital staff.Shutterstock
What are the implications for health care?
At the most basic level, the specialised health-care workforce is core to health-care delivery; without nurses, doctors and allied health staff, theres no health-care system.
Infections in this group whether confirmed outbreaks or suspected contamination will reduce health-care workforce capacity.
High rates of staff off work due to COVID-19 may also increase fatigue and burnout in the remaining workforce, adding to the burden.
The greater the scope of these outbreaks, the greater the strain on the affected hospitals and the health-care system. This will be compounded as theyre faced with increased demand due to COVID-19 cases in the community.
Even in a pandemic, continue with routine health care and don’t ignore a medical emergency
Australia has had time to prepare its workforce with additional skills and capabilities in critical care. But there are always concerns regarding potential workforce shortages in the height of a pandemic, particularly in areas of specialised practice such as intensive care.
Especially in hotspots, as we weather this second wave, there remains a risk demand could outweigh supply.
What can the health system do to cope?
A number of possible interventions could increase system capacity and help manage demand.
This may include decreasing elective or non-urgent surgery, as we saw during the first wave of the virus.
Increasing the use of virtual models of care including phone consultations and telehealth, where appropriate, could also help ease the pressure. Quarantined frontline workers could provide virtual care through telephone support, such as helplines or other telehealth services.
A reduced health-care workforce can put added stress on remaining staff.Shutterstock
Adapting care to minimise the movement and interaction of hospital staff across wards and sites is another important option. For example, some hospitals have shifted from a model where a team of doctors works across multiple wards to a small team of doctors providing care to only one ward.
Most hospitals have also set-up dedicated COVID wards to screen patients for COVID-19 at the first point of contact with the health system.
What about routine testing for health workers?
To sustain a prolonged response to this crisis we need a healthy, COVID-19 free workforce. Especially given we know many positive cases dont experience symptoms, we should be mass testing health-care workers.
To date, weve seen some testing of asymptomatic health-care workers in Victoria, but it has not been commonplace.
Increased routine screening of health-care workers, with or without suspected exposure, will increase the number of days away from work while staff wait for results, reducing service capacity. But the pay-off will be greater it will limit COVID-19 spread.
‘The doctor will Skype you now’: telehealth may limit coronavirus spread, but there’s more we can do to protect health workers
Keeping our health-care heroes safe and well
From this week, staff at several major Melbourne hospitals have been required to wear masks at all times while at work. These precautions have previously been reserved for staff in areas of higher clinical risk such as emergency and intensive care.
This is in addition to a range of guidelines health professionals follow to minimise the spread of COVID-19, including around hand hygiene, cleaning, PPE, and keeping physical distance from patients where possible.
But the responsibility to take precautions and stop the spread falls to all of us.
Hospital patients and visitors are also being encouraged to wear face masks.
In fact, everyone in Melbourne is now advised to wear a mask in public when social distancing is not possible. Hopefully this will go some way to protecting our health-care workers and the entire community.
Health-care workers share our trauma during the coronavirus pandemic on top of their own
Researchers set up Gate2Brain to exploit a novel drug-transporting technology – News-Medical.Net
Researchers from IRB Barcelona, the University of Barcelona (UB) and the Sant Joan de Déu Research Institute – Hospital Sant Joan de Déu (SJD) have set up Gate2Brain, a company based on a novel technology developed at IRB Barcelona to transport drugs into the…
Researchers from IRB Barcelona, the University of Barcelona (UB) and the Sant Joan de Déu Research Institute – Hospital Sant Joan de Déu (SJD) have set up Gate2Brain, a company based on a novel technology developed at IRB Barcelona to transport drugs into the brain.
Gate2Brain is the second joint spin-off between IRB Barcelona and the UB to be funded by the Mind the Gap Programme run by the Botín Foundation.
Driven by IRB Barcelona associate researcher Meritxell Teixidó, Gate2Brain combines several families of peptides able to cross the blood-brain barrier, a structure that hinders access of most drugs to the brain.
The brain is a precious organ that is strongly protected by a kind of wall. We have managed to develop “keys” that facilitate entry and that we believe could allow different drugs to enter the brain and treat diseases of this organ.”
Meritxell Teixidó, Associate Researcher, IRB Barcelona
The pharmaceutical industry has invested millions of euros in the development of drugs that ultimately did not cross the blood-brain barrier and have consequently been unsuccessful.
Gate2Brain has been set up to exploit the technology developed over the last 15 years in the Peptide and Protein Laboratory headed by Ernest Giralt (Professor at the UB) at IRB Barcelona, in which Teixidó is a Research Associate.
The research line that Teixidó has led in recent years has produced three families of shuttle peptides with the ability to cross the blood-brain barrier and deliver therapeutic molecules to the brain that cannot cross it unaided.
In addition to IRB Barcelona, the UB has also participated in the development of these families of peptides, and the Sant Joan de Déu Hospital has also been involved in the development of the first product.
The advantages of this technology include the possibility to improve the effectiveness of many treatments, as well as to reduce the amount of drug administered and thus limit side effects.
A multidisciplinary team to drive the company’s growth
Gate2Brain has come about with an initial investment of €500,000 from the Mind the Gap Programme run by the Botín Foundation.
In its previous stage, this research line was supported by “la Caixa” Foundation’s CaixaImpulse Programme, to advance with the preclinical study for a specific type of pediatric glioma.
A year ago, the technology also received funding from the Agency for the Management of University and Research Grants (AGAUR) in the “Funding for the Knowledge Industry- PRODUCTE” call.
The new company will be based at the Barcelona Science Park, while the experimental work will be conducted at the Sant Joan de Déu Hospital.
The company plans to advance the development of a drug to treat a type of childhood brain cancer, as well as evaluate the performance of the drug transport platform in other diseases that require therapeutic agents to cross the blood-brain barrier.
In addition to Teixidó, Gate2Brain has founding partners with a multidisciplinary profile, bringing expertise in basic peptide and protein research, pharmaceutical development, clinical expertise in pediatric oncology, and business insight to drive the company’s growth.
According to Teixidó, “the company launch today is the result of the collective success of the research groups and Innovation departments, which I want to thank for their work.
We have worked shoulder to shoulder during all this time to finally make the company a reality.”
The sixth spin-off created by IRB Barcelona to date
Transfer and innovation are key for IRB Barcelona and, since the launch of the institute, its Innovation Department has promoted the setup of six spin-offs.
Its director, Francesc Posas, says, “We are very proud that nearly 15 years of research at IRB Barcelona bear fruit and have brought about a new spin-off as promising as Gate2Brain.”
“In the coming years, we intend to continue to foster spin-offs derived from the fundamental biomedical research done in our centre–companies that will ultimately benefit patients with diseases for which there is currently no cure.”
As the unit for technology transfer and innovation at the University of Barcelona, the Bosch i Gimpera Foundation (FBG) is responsible for transferring research results to society through the creation of spin-offs, patent licensing, and through contracts with companies and institutions, thus contributing to the competitiveness of the business fabric and to the improvement of social well-being.
In 2019, 826 projects were managed and received €33.85 M funding. Gate2Brain is the 46th spin-off created by the FBG-UB, 28 of which involve participation of the UB.
Backing from Mind the Gap
Since 2010, the Botín Foundation’s Mind the Gap Programme has been promoting entrepreneurship in the Life Sciences in order to help technologies produced by Spanish centres reach the market and generate socio-economic development.
To this end, it invests financial (€500,000) and management resources, the latter through an expert advisor who provides guidance and support in the critical aspects of project viability.
Since 2016, in addition to the Botín Foundation, Mind the Gap has been operating through a co-financing vehicle involving the participation of a group of private investors.
Gate2Brain joins the eight companies that already form part of the Mind the Gap Programme. To date, these companies have secured €16 M of investment.
They have a combined annual turnover of €1.5 M, and in 2019 they provided 53 highly qualified jobs.
Upcoming phase II study on high risk of triple negative breast cancer recurrence – News-Medical.net
Indiana University School of Medicine researchers Milan Radovich, PhD, and Bryan Schneider, MD, have discovered that the presence of circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) in the plasma of women’s blood who have undergone chemotherap…
Indiana University School of Medicine researchers Milan Radovich, PhD, and Bryan Schneider, MD, have discovered that the presence of circulating tumor DNA (ctDNA) and circulating tumor cells (CTCs) in the plasma of women’s blood who have undergone chemotherapy prior to surgery for the treatment of stage 1, 2 or 3 triple negative breast cancer are critical indicators for the prediction of disease recurrence and disease-free survival.
Their findings, published today in the prestigious international peer-reviewed journal, JAMA Oncology allow for a stratification of patients in clinical trials around the world, that didn’t exist prior to their discovery. The pair also spoke about their findings as part of a JAMA Oncology podcast.
These findings from the Vera Bradley Foundation Center for Breast Cancer Research, located at IU School of Medicine, enable a scientific basis for predicting relapse and disease-free survival, which are both important questions for women who live in constant fear of their disease returning,”
Jay L. Hess, MD., PhD., MHSA and Dean, IU School of Medicine
“The discoveries reflect our long history as leaders in genomics, bioinformatics and medical innovation.”
Specifically, Radovich and Schneider, who are also researchers at the IU Melvin and Bren Simon Comprehensive Cancer Center, along with colleagues from the Hoosier Cancer Research Network, analyzed plasma samples taken from the blood of 196 women, as part of a preplanned secondary analysis of women who were participants in clinical study BRE12-158.
This is the largest known data set of patients to date.
They discovered that the detection of ctDNA was significantly associated with poorer outcomes on three important measures for patients: distant disease-free survival, disease-free survival and overall survival.
When the presence of ctDNA was combined with the presence of CTCs, the outcomes were even worse.
- At two years post-surgery and chemotherapy, distant disease-free survival for women with the presence of ctDNA in their blood was 56 percent, when compared with 81 percent for women without ctDNA.
- Patients with the presence of both ctDNA and CTCs at two years had a 52 percent likelihood of distant disease-free survival versus 89 percent who were negative for both markers.
Approximately one-third of patients will achieve remission from their triple negative breast cancer, following surgery and chemotherapy.
However, two-thirds will have residual disease, putting them at high risk of relapse. These findings will be the focus of the PERSEVERE study, which will stratify women with triple negative breast cancer based on being ctDNA positive and assign them a targeted therapy matched to the patient’s genomic sequencing.
The study is powered to help discover a personalized therapy for patients at high risk for relapse and for whom no treatments currently exist. More information about the PERSEVERE study will be provided in the coming months.
“A diagnosis of triple negative breast cancer is very scary to the patient.”
“The discovery and utilization of circulating tumor DNA and circulating tumor cells to better predict recurrence, by Drs. Schneider and Radovich, has provided a huge step forward toward more certainty for treatment decision making,” said Mary Lou Smith, co-founder of the Research Advocacy Network.
“This significant scientific advancement will help personalize treatments for those still battling residual disease.”
“Since uncovering these findings in women diagnosed with triple negative breast cancer, we have learned that others are applying this stratification of patients based on ctDNA and CTCs to other cancers, including breast and colon,” said Radovich.
“This is an important step forward in the treatment of women with triple negative breast cancer, who have not had much scientific evidence to point to–until now–for treatment of their disease,” said Schneider.
“We are going to use these findings and continue on until we find a treatment that works for each individual woman. This effort not only involves finding the best way to kill cancer, but to minimize side effects.”
As a further testament to the significance of these findings, Radovich presented the initial findings as part of an oral, plenary session on December 13, 2019, at the San Antonio Breast Cancer Symposium, the most influential gathering of breast cancer researchers and physicians in the world.
Indiana University School of Medicine
Radovich, M. et al. (2020) Association of Circulating Tumor DNA and Circulating Tumor Cells After Neoadjuvant Chemotherapy With Disease Recurrence in Patients With Triple-Negative Breast Cancer. JAMA Oncology. doi.org/10.1001/jamaoncol.2020.2295.
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